Designing a survivorship and supportive care center at a comprehensive cancer center.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 159-159
Author(s):  
Katharine Amato ◽  
Kathryn M. Glaser ◽  
Lynda M. Beaupin ◽  
Denise A. Rokitka ◽  
Mary E. Reid
Keyword(s):  
Supportive Care ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Nutrition Education ◽  
Care Center ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Clinic ◽  
Gastrointestinal Problems ◽  
Integrative Therapies

159 Background: Unmet physical, psychosocial, and other support needs of cancer survivors may lead to increased distress, anxiety, and decreased quality of life. Survivorship Clinics may be tailored for specific issues identified through a needs assessment. Methods: An invitation to complete a web-based survey was mailed to 35,420 active patients at a comprehensive cancer center in November 2015. The survey domains included demographics, cancer history, comorbidities, lifestyle, cancer prevention, spiritual and emotional support, symptom management, and interest in specific services. Results: 1,054 surveys were completed. The majority of respondents were female (55.2%; n = 582/1054), had Stage I cancer at diagnosis (43.9%; n = 360/820), and had completed treatment (69.0%; n = 727/1054). Genitourinary (23.0%; n = 238/1034) and breast (20.5%; n = 212/1034) were the most common cancer types among the respondents. Participants identified an average of 4.60 side effects experienced during or after treatment (n = 804); the most common were fatigue (64.5%), pain (37.3%), weight change (33.4%), sleep disturbance (30.2%), and gastrointestinal problems (29.4%). One third of participants reported having a physical side effect that caused anxiety and emotional distress (33.3%; n = 331/995), in particular, sexual function (69.7%; n = 136/195) and cognitive dysfunction (43.6%; n = 85/195). A total of 23.9% of participants had financial concerns due to costs of cancer treatment (n = 238/955). Participants were interested in integrative therapies, most notably yoga (75.1%; n = 289/385), acupuncture (72.4%; n = 155/214), aerobics (62.3%; n = 240/385), Swedish massage (60.5%; n = 225/372), aromatherapy (60.2%; n = 224/372), and homeopathy (55.1%; n = 118/214). Most respondents endorsed wanting information on nutrition (81.5%; n = 380/466). Conclusions: Cancer survivors report vast physical and psychosocial needs during and after cancer treatment, and they have a high interest in nutrition education and integrative therapies. Improved care coordination from a dedicated cancer survivorship and supportive care clinic at a comprehensive cancer center may specifically address survivors’ issues.

scholarly journals Challenges of Managing Advanced Cancer Patients through Phone Triaging at an Outpatient Supportive Care Clinic: A Case Series of Palliative Care Patients

2012 ◽  
Vol 6 ◽  
pp. PCRT.S10733
Author(s):  
Lindsey E. Pimentel ◽  
Sriram Yennurajalingam ◽  
Elizabeth D. Brown ◽  
Debra K. Castro
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Advanced Cancer ◽  
Case Reports ◽  
Care Center ◽  
Case Series ◽  
Cancer Center ◽  
Advanced Cancer Patients ◽  
Care Clinic ◽  
Outpatient Supportive Care

Palliative care strives to improve the quality of life for patients and their families by impeccable assessment and management using an interdisciplinary approach. However, patients with cancer-related pain and other symptoms tend to be undertreated because of limited follow-up visits due to late referrals and logistics. Thus, patients who present to the outpatient Supportive Care Center at The University of Texas MD Anderson Cancer Center often experience severe physical and psychological symptoms. The two case reports presented highlight the challenges of managing distressed patients with advanced cancer in the outpatient setting. These descriptions focus on addressing patient needs over the phone to enhance the care patients receive at the Supportive Care Center. Future prospective studies are needed to measure the effectiveness of using phone triaging in conjunction with standard outpatient palliative care.

scholarly journals P135 Snapshot of an Outpatient Supportive Care Center at a Comprehensive Cancer Center

2016 ◽  
Vol 52 (6) ◽  
pp. e101
Author(s):  
Lindsey E. Pimentel ◽  
Maxine De la Cruz ◽  
Angelique Wong ◽  
Debra Castro ◽  
Eduardo Bruera
Keyword(s):  
Supportive Care ◽  
Care Center ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Outpatient Supportive Care

The development of a nomogram to determine the risk for inappropriate opioid use in cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11602-11602
Author(s):  
Sriram J. Yennu ◽  
Rony Dev ◽  
Tonya Edwards ◽  
Joseph Anthony Arthur ◽  
Zhanni Lu ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Financial Distress ◽  
Comprehensive Cancer Center ◽  
Multivariate Logistic Regression Model ◽  
Cancer Center ◽  
Opioid Use ◽  
Care Clinic ◽  
Validated Questionnaire ◽  
Edmonton Symptom Assessment Scale

11602 Background: Non-Medical opioid use is a growing crisis. Cancer patients at risk of harmful use of prescribed opioids are frequently underdiagnosed. The aim was to develop a nomogram to predict the probability of occurrence of Inappropriate opioid use that is, presence of SOAPP ≥ 7) among patients receiving outpatient supportive care consultation at a comprehensive cancer center. Methods: 3588 consecutive cancer patients referred to a supportive care clinic from March 1, 2016 to July 15, 2018 were reviewed. Patients were eligible if they had diagnosis of cancer, and were on opioids for pain for at least a week. All patients were assessed using Edmonton Symptom Assessment Scale with spiritual pain and financial distress (ESAS-FS), MEDD (morphine equivalent daily dose), SOAPP-14 (validated questionnaire for assessment of risk of inappropriate opioid use, and CAGE-AID (screening questionnaire for alcoholism/substance use disorder). Patients at with SOAPP+ were defined by SOAPP score ≥7. A nomogram was devised based on the risk factors determined in the multivariate logistic regression model and it can be used to estimate the probability of inappropriate opioid use. Results: Median age was 62yrs. Median ESAS pain item score on consultation was 5, Median ECOG was 2.20.4% were SOAPP+ and 10.1% were CAGE-AID+. SOAPP+ was significantly associated with gender, race, marital status, smoking status, depression, anxiety, financial distress, MEDD and CAGE score. The C-index is 0.8(CI 0.78, 0.82). A nomogram was developed. For example, for a male Hispanic patient, who is married, never smoked, with the following ESAS scores: (depression = 3, anxiety = 3, financial distress = 8), CAGE score of 0, and MEDD of 20, the total score is 9+9+0+0+6+10+26+0+1 = 61. In the nomogram a score of 58 indicates the probability of inappropriate opioid use being 0.1 and a score of 88 indicates the probability of 0.2. Based on the patient’s total score of 61, the probability of his aberrant behavior is between 10% to 20% (close to 10%). Conclusions: A nomogram can predict the risk of inappropriate opioid use in cancer patients.

The development of a nomogram to determine the frequency of elevated risk for non-medical opioid use in cancer patients

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Sriram Yennurajalingam ◽  
Tonya Edwards ◽  
Joseph Arthur ◽  
Zhanni Lu ◽  
Elif Erdogan ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Financial Distress ◽  
Elevated Risk ◽  
Comprehensive Cancer Center ◽  
Multivariate Logistic Regression Model ◽  
Cancer Center ◽  
Opioid Use ◽  
Care Clinic ◽  
Edmonton Symptom Assessment Scale

Abstract Objective Non-medical opioid use (NMOU) is a growing crisis. Cancer patients at elevated risk of NMOU (+risk) are frequently underdiagnosed. The aim of this paper was to develop a nomogram to predict the probability of +risk among cancer patients receiving outpatient supportive care consultation at a comprehensive cancer center. Method 3,588 consecutive patients referred to a supportive care clinic were reviewed. All patients had a diagnosis of cancer and were on opioids for pain. All patients were assessed using the Edmonton Symptom Assessment Scale (ESAS), Screener and Opioid Assessment for Patients with Pain (SOAPP-14), and CAGE-AID (Cut Down-Annoyed-Guilty-Eye Opener) questionnaires. “+risk” was defined as an SOAPP-14 score of ≥7. A nomogram was devised based on the risk factors determined by the multivariate logistic regression model to estimate the probability of +risk. Results 731/3,588 consults were +risk. +risk was significantly associated with gender, race, marital status, smoking status, depression, anxiety, financial distress, MEDD (morphine equivalent daily dose), and CAGE-AID score. The C-index was 0.8. A nomogram was developed and can be accessed at https://is.gd/soappnomogram. For example, for a male Hispanic patient, married, never smoked, with ESAS scores for depression = 3, anxiety = 3, financial distress = 7, a CAGE score of 0, and an MEDD score of 20, the total score is 9 + 9+0 + 0+6 + 10 + 23 + 0+1 = 58. A nomogram score of 58 indicates the probability of +risk of 0.1. Significance of results We established a practical nomogram to assess the +risk. The application of a nomogram based on routinely collected clinical data can help clinicians establish patients with +risk and positively impact care planning.

scholarly journals Achievement of personalized pain goal in cancer patients referred to a supportive care clinic at a comprehensive cancer center

Cancer ◽  
2011 ◽  
Vol 118 (15) ◽  
pp. 3869-3877 ◽  
Author(s):  
Shalini Dalal ◽  
David Hui ◽  
Linh Nguyen ◽  
Ray Chacko ◽  
Cheryl Scott ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Clinic

Snapshot of an Outpatient Supportive Care Center at a Comprehensive Cancer Center

2017 ◽  
Vol 20 (4) ◽  
pp. 433-436 ◽  
Author(s):  
Lindsey E. Pimentel ◽  
Maxine De La Cruz ◽  
Angelique Wong ◽  
Debra Castro ◽  
Eduardo Bruera
Keyword(s):  
Supportive Care ◽  
Care Center ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Outpatient Supportive Care

scholarly journals A culturally specific dietary plan to manage weight gain among African American breast cancer survivors

2012 ◽  
Vol 21 (2) ◽  
pp. 97-105 ◽  
Author(s):  
Kathleen A Griffith ◽  
Renee Royak-Schaler ◽  
Kim Nesbitt ◽  
Min Zhan ◽  
Adriane Kozlovsky ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Vegetable Intake ◽  
Survival Rates ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Daily Consumption ◽  
Culturally Specific ◽  
Fat Consumption

Breast cancer survival rates are lower in African Americans (AAs) than in Caucasians, owing in part to a higher prevalence of obesity in the former, which increases the risk of recurrence and mortality. The Women’s Intervention Nutrition Study (WINS) found that Caucasian women who followed a low-fat eating plan experienced a lower rate of cancer recurrence than women who maintained their usual diets. The purpose of this study was to test the feasibility of a WINS plan tailored to the cultural needs of AA breast cancer survivors. This feasibility pilot study was conducted at a university National Cancer Institute-designated comprehensive cancer center outpatient clinic with AA breast cancer survivors. The culturally specific WINS (WINS-c) plan included eight individual counseling sessions, five educational group meetings, and follow-up telephone calls over a 1-year period. Outcome measures included dietary fat, triglyceride, insulin and glucose levels, and fruit and vegetable intake. Participants ( n = 8) had a mean age of 61.1 years (standard error of the mean (SEM) 3.1 years) and a mean BMI of 32 kg/m2 (SEM 4.25 kg/m)2. Baseline daily fat consumption decreased from 64.6 g (range 36.8–119.6g) to 44.0 g (21.6–73.4g) at 52 weeks ( p = 0.07). Mean daily consumption of fruits and vegetables increased by 36% and 15%, respectively. Mean triglyceride levels decreased at 12 months ( p < 0.05). Sustained hyperinsulinemia was noted in most participants, including those without diabetes. Mean calcium and vitamin D consumption decreased over the 1-year study period. In AA breast cancer survivors, the WINS-c program resulted in a trend toward reduced fat consumption and may represent a sustainable approach in this population for improvement of diet quality after breast cancer.

Sign in / Sign up

Export Citation Format

Share Document